University of Illinois at Chicago, Division of Pulmonary and Critical Care, Chicago.
University of Illinois at Chicago, Division of Pulmonary and Critical Care, Chicago.
Am J Med. 2014 Sep;127(9):886.e1-8. doi: 10.1016/j.amjmed.2014.05.010. Epub 2014 May 20.
Chronic pulmonary diseases are chronic diseases that affect the airways and lung parenchyma. Examples of common chronic pulmonary diseases include asthma, bronchiectasis, chronic obstructive lung disease, lung fibrosis, sarcoidosis, pulmonary hypertension, and cor pulmonale. Pulmonary infection is considered a significant cause of mortality in patients with chronic pulmonary diseases. Streptococcus pneumoniae is the leading isolated bacteria from adult patients with community-acquired pneumonia, the most common pulmonary infection. Vaccination against S. pneumoniae can reduce the risk of mortality, especially from more serious infections in both immunocompetent and immunocompromised patients. Patients with chronic pulmonary diseases who take steroids or immunomodulating therapy (eg, methotrexate, anti-tumor necrosis factor inhibitors), or who have concurrent sickle cell disease or other hemoglobinopathies, primary immunodeficiency disorders, human immunodeficiency virus infection/acquired immunodeficiency syndrome, nephrotic syndrome, and hematologic or solid malignancies should be vaccinated with both 13-valent pneumococcal conjugate vaccine and the pneumococcal polysaccharide vaccine 23-valent.
慢性肺部疾病是指影响气道和肺实质的慢性疾病。常见的慢性肺部疾病包括哮喘、支气管扩张、慢性阻塞性肺疾病、肺纤维化、结节病、肺动脉高压和肺心病。肺部感染被认为是慢性肺部疾病患者死亡的重要原因。肺炎链球菌是成人社区获得性肺炎中最常见的肺部感染的主要分离菌。接种肺炎链球菌疫苗可以降低死亡率，尤其是对免疫功能正常和免疫功能低下的患者的严重感染。接受类固醇或免疫调节治疗（如甲氨蝶呤、抗肿瘤坏死因子抑制剂）的慢性肺部疾病患者，或患有镰状细胞病或其他血红蛋白病、原发性免疫缺陷病、人类免疫缺陷病毒感染/获得性免疫缺陷综合征、肾病综合征以及血液系统或实体恶性肿瘤的患者，应同时接种 13 价肺炎球菌结合疫苗和 23 价肺炎球菌多糖疫苗。
